Lupus & antiphospholipid syndrome
Evaluating a guideline-aligned prednisone threshold within the Lupus Low Disease Activity State (LLDAS): associations with damage accrual
Authors' conclusion
Longer time in LLDAS-5 was robustly associated with less damage accrual. Crude full-cohort analyses suggested a numerically stronger inverse association and slightly better model fit for LLDAS-5, but this apparent advantage was not sustained after multivariable adjustment.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE), including incident cases105 incident cases
- Participants
- 332 patients
- Exposure
- Time in LLDAS-5 (prednisone-equivalent ≤5 mg/day) vs time in LLDAS-7.5 (≤7.5 mg/day), each associated with damage accrual
- Outcome
- Yearly SLICC/ACR DI (SDI) worsening occasions, by average proportion of follow-up in LLDAS-5 and LLDAS-7.5
Methodological detailspatient-level Poisson regression with Huber's robust variance estimator, parallel models for the two definitions, multivariable adjustment
- Patient-level Poisson regression with Huber's robust variance estimator
- Parallel models for the two definitions
- Multivariable adjustment
Main finding
As reported in the abstract
SDI worsening (damage accrual), full cohort
Estimate (95% CI)P value
LLDAS-5
crude RR 0.61(0.37–1.00)
P = 0.052LLDAS-7.5
crude RR 0.73(0.39–1.37)
P = 0.332LLDAS-5
multivariable RR 0.56(0.37–0.86)
P = 0.007LLDAS-7.5
multivariable RR 0.47(0.27–0.85)
P = 0.012- Patients with at least one SDI increase
- 142/332
- SDI increase occasions
- 190
Observational data: associations, not effects.
Further findings
SDI worsening, incident cases (subgroup)
| RR (95% CI) | P value | ||
|---|---|---|---|
| LLDAS-5 | 0.31 (0.11–0.89) | P = 0.029 | |
| LLDAS-7.5 | 0.29 (0.09–0.93) | P = 0.036 | |
| 0.050.21520Relative risk (log scale) |
- SDI worsening, incident cases (subgroup) — Incident patients accruing damage
- 29/105
- SDI worsening, incident cases (subgroup) — Damage occasions
- 29
Original publication
Evaluating a guideline-aligned prednisone threshold within the Lupus Low Disease Activity State (LLDAS): associations with damage accrual. RMD Open. Published 23 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →